Comparison between Transabdominal Preperitoneal Approach and the Totally Extraperitoneal Approach for Inguinal Hernia Repair on the Effect on Testicular Blood Flow

Albahy, Abdel-Rahman; Abu Sheasha, Mohamed; Elghrieb, Ahmed; El-Adalany, Mohamed; Beshir, Magdy

doi:10.21608/ejhm.2022.243010

Comparison between Transabdominal Preperitoneal Approach and the Totally Extraperitoneal Approach for Inguinal Hernia Repair on the Effect on Testicular Blood Flow

Authors

¹ Departments of 1General Surgery

² 2Diagnostic Radiology, Faculty of Medicine, Mansoura University, Egypt

10.21608/ejhm.2022.243010

Abstract

Background: Inguinal hernia repairs are one of the most common procedures performed in general surgery departments. Various techniques have been used to repair inguinal hernias. But now only 3 methods are generally accepted as the best evidence-based treatment options for inguinal hernia repair: the Shouldice technique, Lichtenstein tension-free repair and laparoscopic repair either via the transabdominal preperitoneal (TAPP) approach or the totally extraperitoneal (TEP) approach. There is limited number of studies that have compared the effects of both techniques on the spermatic cord and testicular functions in long term. Objective: The aim of the current work was to compare the effect of laparoscopic inguinal hernioplasty either totally extraperitoneal (TEP) approach or transabdominal preperitoneal (TAPP) approach on testicular blood flow and volume on the same side of the hernia repair.
Patients and methods: This prospective study was performed on 47 male patients admitted to general surgery ward at Mansoura University Hospital between February 2019 and February 2020 with clinically diagnosed inguinal hernias and fulfilling the eligibility criteria. The study population was distributed into 2 groups by computer generating program; Group A that included 28 patients with inguinal hernia who were operated by laparoscopic techniques (TAPP) approach and group B that included 19 patients with inguinal hernia who were operated laparoscopically by (TEP) approach.
Results: There is non-statistically significant higher improvement in resistive index (RI) in TEP group than TAPP at levels of Testicular and Capsular Artery but the same percentage of improvement at the level of intratesticular artery.
Conclusion: It could be concluded that laparoscopic inguinal hernioplasty either TAPP or TEP approaches are safe regarding testicular blood flow but also, they improve it.